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Medicare Reimbursement for Revision Arthroplasty Procedures Decrease Over 20+ Years, a Concerning Trend for
Timothy W Kouo1,2, Coltin R Gerhart3, David N Shau1,2
1Department of Orthopedic Surgery, Anne Burnett Marion School of Medicine at Texas Christian University, Fort Worth, Texas.
Orthopedic surgeons are performing more revision arthroplasty procedures, including hip and knee replacements, but receiving lower inflation-adjusted reimbursement. This trend highlights a need to reassess current reimbursement policies to ensure access to quality care.
Area of Science:
- Orthopedics
- Health Economics
- Healthcare Policy
Background:
- Primary arthroplasty procedures have seen increased volume and decreased physician reimbursement.
- Trends in revision arthroplasty reimbursement and volume have not been extensively studied.
Purpose of the Study:
- To investigate trends in procedure volume and physician reimbursement for revision hip, knee, ankle, elbow, shoulder, and wrist arthroplasty.
- To analyze data from 2000 to 2021 to understand economic shifts in revision arthroplasty.
Main Methods:
- Analysis of Medicare Part B National Summary Data File.
- Extraction of Current Procedural Terminology (CPT) codes for revision arthroplasty procedures.
- Collection of total procedures, billed amounts, and reimbursed amounts; monetary values adjusted to 2021 USD.
Main Results:
- Procedure volume increased for most revision arthroplasty codes between 2000 and 2021.
- Inflation-adjusted reimbursement decreased for most codes, except for CPT code 24370.
- CPT codes 27137 and 24370 showed a decrease in procedure volume.
Conclusions:
- Orthopedic surgeons face rising revision arthroplasty volumes with declining inflation-adjusted reimbursement.
- Reimbursement has not kept pace with inflation, impacting physician compensation.
- Current policies may affect access to quality revision arthroplasty care, necessitating a policy reassessment.
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